Menstrual Irregularities: Clomid, Endometrial Thickening, and Contraception

Endometrial thickening, menstrual induction medication?

Hello doctor, a few months ago I had an ultrasound and the doctor said I have polycystic ovary syndrome.
My last menstrual period started on April 7, which was induced by medication.
I was supposed to get my period on May 7, but on May 9, I had something resembling a menstrual flow that stopped the next day.
On May 11, during an ultrasound, it was noted that my endometrium was thickened, but it was uncertain when my period would come.
I was prescribed a course of medication to induce menstruation (four days' worth, taking two pills each morning and evening) along with some oral contraceptives.
After finishing the medication, my period still did not arrive, so I was advised to return for a follow-up.
On May 12, I accidentally had unprotected intercourse with my partner, and there was ejaculation inside.
I started taking the medication to induce menstruation on May 12.
I called the pharmacist, and she said I could take the contraceptive pill that same day.
I would like to ask: 1.
What are the ingredients in the medication to induce menstruation? 2.
With a thickened endometrium, is there a risk of pregnancy from unprotected intercourse, especially since I took the contraceptive pill that day? 3.
Can I take the contraceptive pill before my period arrives? 4.
What happens if I take the medication to induce menstruation and the contraceptive pill together?

Mi, 20~29 year old female. Ask Date: 2022/05/12

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello,
The main ingredient in menstrual induction medications is usually progesterone.
Based on your description, it is possible to be pregnant.
If this is your first time taking birth control pills, it is recommended to start taking them on the first day of your menstrual cycle.
If you start taking the pills after the second day of your period, it is advised to use additional contraceptive measures for the first seven days of taking the pills.
If you have taken the menstrual induction medication and still do not get your period after a week, please consult a physician for further evaluation and testing.

Thank you! Wishing you peace and health.

Dr.
Zhang

Reply Date: 2022/05/12

More Info

Understanding menstrual irregularities can be complex, especially when considering conditions like polycystic ovary syndrome (PCOS), the use of medications such as Clomid (clomiphene citrate), and the implications of endometrial thickening. Let's address your questions one by one while providing some context about the underlying issues.

1. What are the components of the menstrual induction medication?
The medication you referred to as "催經藥" (menstrual induction medication) typically contains synthetic hormones. Commonly, these medications may include progestins, which are synthetic forms of progesterone. Progestins help to regulate the menstrual cycle by mimicking the natural hormone's effects, leading to the shedding of the uterine lining when taken for a specific duration. If you were prescribed a specific medication, it would be beneficial to check the label or consult your healthcare provider for the exact composition.

2. If the endometrium is thickened, is there a risk of pregnancy after unprotected intercourse?
Thickening of the endometrium can occur for various reasons, including hormonal imbalances often seen in conditions like PCOS. If you had unprotected intercourse on May 12, and considering that you were taking menstrual induction medication, there is a possibility of pregnancy, especially if ovulation occurs. However, if you were also taking contraceptive pills, they are designed to prevent ovulation and reduce the likelihood of pregnancy. The effectiveness of the contraceptive pill can be influenced by various factors, including timing and adherence to the regimen.

3. Can contraceptive pills be taken before menstruation starts?
Yes, contraceptive pills can be taken even if menstruation has not started. In fact, many women begin taking the pill at any point in their cycle, and it can help regulate cycles over time. However, if you are starting the pill while experiencing irregular cycles, it may take some time for the body to adjust, and it is essential to use additional contraception for the first seven days of starting the pill to ensure effectiveness.

4. What happens if menstrual induction medication and contraceptive pills are taken together?
Taking menstrual induction medication and contraceptive pills together can lead to hormonal interactions. While progestins in menstrual induction medications can help regulate the cycle, contraceptive pills contain both estrogen and progestin to prevent ovulation. If taken simultaneously, it is crucial to follow your healthcare provider's instructions, as this combination may alter the effectiveness of either medication. It is advisable to discuss any potential interactions with your healthcare provider or pharmacist.

In summary, managing menstrual irregularities, especially with conditions like PCOS, requires careful monitoring and communication with your healthcare provider. If you are experiencing persistent irregularities or have concerns about potential pregnancy, it is essential to follow up with your doctor for personalized advice and possible further evaluation. They can provide guidance on the best course of action based on your specific health needs and circumstances. Always prioritize open communication with your healthcare team to ensure you receive the most accurate and relevant information for your situation.

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